Individual
MS. DEANNA LYNN KUDULIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
8831 VILLA LA JOLLA DR, LA JOLLA, CA 92037-1949
(858) 457-4480
Mailing address
8831 VILLA LA JOLLA DR, LA JOLLA, CA 92037-1949
(661) 972-5317
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
15849
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1285715052
—
CA
Enumeration date
10/18/2006
Last updated
06/12/2019
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